室壁运动积分与左室射血分数对急性心肌梗死后心力衰竭的预测

发布时间：2018-03-29 17:30

本文选题：急性心肌梗死　切入点：心力衰竭　出处：《实用医学杂志》2017年01期

【摘要】：目的:探讨室壁运动积分(WMS)与左室射血分数(LVEF)对急性心肌梗死(AMI)后心力衰竭(HF)的预测效力。方法:连续入选2014年1-11月我科CCU住院的AMI患者,发病48 h内检测WMS及LVEF。随访12个月,记录其发生HF情况。结果:共入选127例AMI患者,发生HF组20例。HF组WMS(23.55±3.73)高于非HF组(20.11±3.13)(P0.01);LVEF低于非HF组(分别为48.77±8.08、56.99±5.17,P0.01);多因素Logistic回归分析显示,WMS(OR=1.22,95%CI:0.91~1.63,P0.05)与LVEF(OR=0.84,95%CI:0.74~0.97,P0.05)均是AMI后心力衰竭的独立危险因素。WMS预测AMI患者6个月发生HF的ROC曲线下面积为0.81(95%CI:0.71~0.92,截点为21.50,敏感度为75%,特异度为85%,P0.01),LVEF预测面积为0.76(95%CI:0.62~0.90,截点为50%,敏感度为40%,特异度为80%,P0.05),两者联合情况下预测面积为0.82(95%CI:0.71~0.94,敏感度为70%,特异性为88%,P0.01)。结论:WMS和LVEF均是AMI患者12个月发生HF的独立预测指标,两者联合使用可提高预测效力。
[Abstract]:Objective: to investigate the predictive efficacy of wall motion score (WMS) and left ventricular ejection fraction (LVEF) in patients with congestive heart failure (CCU) after acute myocardial infarction (AMI). Methods: AMI patients hospitalized in our department from January to November 2014 were enrolled. WMS and LVEF were detected within 48 hours after onset of acute myocardial infarction (AMI) and followed up for 12 months. Results: a total of 127 patients with AMI were enrolled. WMS(23.55 卤3.73 in HF group was higher than that in non-HF group (20.11 卤3.13). LVEF in HF group was significantly lower than that in non-HF group (48.77 卤8.08 卤56.99 卤5.17). Multivariate Logistic regression analysis showed that Logistic regression analysis showed that Logistic regression analysis showed that both WMS(23.55 and LVEFORO were independent risk factors for heart failure after AMI. WMS predicted the occurrence of HF in AMI patients at 6 months under ROC curve. The area is 0.81-95CI: 0.72, the cut-off point is 21.50, the sensitivity is 75 and the specificity is 850.7695. The predicted area of LVEF is 0.7695 CI: 0.620.90, the cut-off point is 50, the sensitivity is 400.The specificity is 8050.The predicted area is 0.8295CI0.771.The sensitivity is 700.The specificity is 885.Conclusion both LVEF and WMS are AMI with P0.050.CONCLUSION: WMS and LVEF are both AMI with P0.050.Conclusion the predicted area is 0.8295CI0.71% 0.940.The sensitivity is 700.The specificity is 885.Conclusion both WMS and LVEF are AMI patients. An independent predictor of HF in 12 months, Combined use of the two can improve prediction effectiveness.
【作者单位】：苏州大学附属第二医院心脏内科;
【基金】：苏州市科技计划项目(编号:kjxw2014013)
【分类号】：R542.22;R541.6

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